Am I responsible if they FAIL to bill Medicare in a timely manner?

by Mark
(Las Vegas, NV)

In august of 2006 I had an outpatient surgery done for which I submitted the only insurance I have, Medicare both A & B, and I paid ALL bills I was aware of in an agreeable manner. I have now, 3.5 YEARS later, been contacted inre a $1224 outstanding bill from a LABORATORY Co. which I NEVER dealt with personally. They apparently did the contract work at the facility where the surgery was performed.

I spoke with the collection agency and explained this to them but they told me "Let me make this perfectly clear, billing your insurance is a COURTESY!". Arrogance and ignorant hard ass attitude, I hung up, cooled off and called back asking, again, for a copy of the original bill as I was not aware of anything unpaid.

Today I received a simple "assignment memo" stating what I just said with NO DETAIL what so ever--NO LIST of services, fees charged or where, who--NOTHING but the dollar amount, date and the lab co. name, nothing that helped me at all know what was done or why.

I live in Nevada, the procedure was done here as well and in FOUR major surgery's since having Medicare I've NEVER had to see, consult or contact the labs for billing info and now this...Any help would be greatly appreciated!

Sincerely,MG

Comments for Am I responsible if they FAIL to bill Medicare in a timely manner?

Unfortunately, your story illustrates some common problems with our health care billing system and debt collection laws. It is not unusual for consumers to first hear about a medical bill from a collection agency. And the collection agency generally has the right to report a collection account to the credit reporting agencies, which damages consumer's credit reports.

You did the right thing by requesting written verification of the debt. Unfortunately, the statement you received was useless. The Federal Trade Commission (FTC) has identified problems with the verification procedures used by some debt collectors and, again, your story illustrates that problem.

While the collection agency states that billing insurance is a courtesy, I am not sure that is correct here. If the medical provider has an contractual arrangement with Medicare, they may be required to bill them according to that arrangement.

I would strongly recommend you talk with a consumer law attorney with experience in debt collection cases. Find out how to get a FREE consultation with a consumer law attorney here. Many debt collection cases are taken on a contingent-fee basis, where you only pay if you win. That's because if you successfully sue under the FDCPA, you may be entitled to damages and attorney fees.

Let me know what happens when you talk with an attorney. If it turns out he/she doesn't think you have a good case, we'll discuss Plan B.